Severe penile hair tourniquet syndrome with near amputation of the glans

Penile hair tourniquet syndrome is a rare phenomenon that classically affects boys during their first few years of life. We report a late presentation of an 8-year old nonverbal, severely autistic male with a several-month-long history of a progressing penile hair tourniquet. The persistence of this constricting band led to severe anatomic defects, including near amputation of the glans, with transection of the urethra creating a distal fistula, and erosion through the majority of the cavernosal bodies. Our case highlights the critical importance of vigilant care and high index of suspicion, particularly in vulnerable patient populations such as young boys with autism spectrum disorder. Urgent evaluation and removal of the offending foreign body is required, with use of sedation or anesthesia if necessary.